Healthcare Provider Details

I. General information

NPI: 1649104142
Provider Name (Legal Business Name): KATHERINE JOHANA MOLINA M.A CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 HOWELLS RD STE 1
BAY SHORE NY
11706-5320
US

IV. Provider business mailing address

54 PALERMO ST
CENTRAL ISLIP NY
11722-3237
US

V. Phone/Fax

Practice location:
  • Phone: 516-404-4891
  • Fax:
Mailing address:
  • Phone: 631-290-9155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: